螺旋CT强化方式在肝脏局灶性病变定性诊断中的价值

目的 探讨螺旋CT强化方式对肝脏局灶性病变的定性诊断价值. 方法 回顾性分析行肝脏螺旋CT多期增强扫描且发现局灶性病变的44例患者(54个病灶)的诊断结果,重点分析各类病灶的强化方式. 结果 (1)78%(14/18)的肝细胞癌表现为"快进快出"的强化方式,83%存在肝硬化背景,22%门脉可见癌栓;(2)9个肝血管瘤表现为"快进慢出",边缘明显强化逐渐向中心充填;(3)4例胆管细胞型肝癌表现为"慢进慢出",部分瘤灶内包埋胆管,周围可见扩张的肝内胆管;(4)14个肝转移瘤和5例肝脓肿表现为环形强化,肝转移瘤为周边程度不一的环形强化,肝脓肿则为单环或多环强化;(5)3例肝局灶性结节增生和1例肝细胞腺瘤表现为"快进慢出",2例局灶性结节增生存在中央瘢痕并延迟强化.结论螺旋CT强化方式能充分显示肝脏局灶性病变的血供特点,对定性诊断有较高的临床价值.

Diagnostic Value of Contrast-Enhanced CT Patterns in Focal Hepatic Lesion

Objective To study the diagnostic value of contrast-enhanced CT patterns in focal hepatic lesions.Methods Contrast-enhanced CT patterns in 44 patients with focal hepatic lesions (54 foci) were retrospectively analysed.Results (1)78% of the hepatocellular carcinoma presented "rapid-filling and rapid-washout" feature.(2)All hepatic hemangioma presented "rapid-filling and slow-washout", progressive opacification from the periphery to center. (3)All cholangiocarcinoma presented "slow-filling and slow-washout" .(4)Metastatic hepatocarcinoma in 14 cases and hepatic abscesses in 5 cases were presented a enhanced ring around the lesion, metastatic hepatocarcinomas showed single ring,however, hepatic abscesses showed multi-ring. (5)Focal nodular hyperplasia in 3 cases and hepatic adenomas in 1 case presented "rapid-filling and slow-washout".Conclusion The contrast-enhanced patterns at spiral CT can fully reflect the blood supply of focal hepatic lesions, it has significant value in diagnosing focal hepatic lesions.